心理咨询中的突然获益：工作同盟及初始症状的影响

对82位当事人在咨询中的症状改变过程进行纵向研究,检验突然获益模式（Sudden Gain, SG）的发生及其与咨询效果的联系,并探索初始症状水平、工作同盟对SG的影响。结果表明,24.93%的当事人经历了SG,咨询效果显著好于其他当事人;SG组与对照组在初始症状水平和总体工作同盟水平上差异显著。结论：SG出现于本土心理咨询中,经历SG的当事人取得了更好的咨询效果,工作同盟与初始症状水平与SG的发生相关。     

工作同盟的结构：基于两种测量工具的检验

以大学心理咨询中心的当事人为样本,对国外两种广泛使用的工作同盟测量工具WAI-S和WAI-SR的结构和测量学指标进行检验。结果发现,WAI-S和WAI-SR的任务一致与目标一致两个维度的相关较高,分别为0.71和0.74;WAI-S和WAI-SR的一因素、二因素和三因素结构均没有得到充分支持;WAI-SR与咨询效果的相关不显著。WAI-S和WAI-SR的结构不能很好反映其所依据的理论假设,提示在对测量工具进行改进的同时,还需要对工作同盟的理论结构进行思考。     

咨询会谈中的人际互补及其与工作同盟、咨询效果的关系

Leary的人际理论将人际互动行为划分为\"情感\"和\"控制\"两个维度,互动双方在情感维度的一致性和控制维度的互补性统称为人际互补。为探究心理咨询过程中人际互补的发展趋势及其与工作同盟、咨询效果的关系,采用电脑操纵杆方法,编制《咨询会谈人际互补行为评分手册》,对16个个案的48个心理咨询会谈录像进行评估。结果表明:有经验的咨询师在咨询前期的情感轴一致性高于中期和后期,在咨询后期的控制轴互补性高于前期和中期,新手咨询师的情感轴一致性和控制轴互补性均无阶段性差异;咨询中期的情感轴一致性负向预测工作同盟和会谈深度;情感轴一致性呈高-低-高发展趋势的个案咨询效果更好。结论:心理咨询的人际互补三阶段模型得到一定程度的支持,其作用机制有待进一步验证。     

阅读进度反馈信息对工作同盟和咨询效果的影响

进度反馈指将对当事人的标准化测量结果和解释反馈给咨询师的干预, 其目的在于矫正咨询师对咨询效果主观评估的偏差, 提高咨询效果。考虑到咨询师和当事人“面对面”的标准反馈程序不符合我国社会文化习惯, 采用多层结构方程模型, 分析了自然情境下非“面对面”的进度反馈对工作同盟和咨询效果的影响。结果发现, 在组间水平, 反馈组的工作同盟质量更好; 在组内水平, 工作同盟与症状是相互预测的关系。在结案时, 反馈组在抑郁症状和咨询的有帮助性上效果更好。结论是进度反馈对工作同盟和咨询效果有积极影响。研究从工作同盟和中国人的关系角度拓展了对进度反馈作用机制的认识, 为进度反馈的应用提供了基于实践干预有效的证据。     

工作同盟和领悟对咨询效果的影响

为了解短程咨询中工作同盟和领悟对咨询效果的影响,以12个个案94次会谈为对象,考察工作同盟、领悟分别与会谈效果、治疗效果的关系,并考察二者共同作用于效果的方式。结果表明,咨访双方评定的工作同盟都可以正向预测会谈效果,但不能预测治疗效果;领悟与会谈有效性正相关,领悟正向预测治疗效果;咨询师评定的同盟的三个维度以领悟为中介影响其对会谈效果的评价。     

心理咨询中工作同盟的发展模式与咨询效果

为了探索工作同盟在咨询过程中的发展模式, 采用Stiles等(2004)提出的4个变化特征参数(shape-of-change parameters)对30个个案的工作同盟在咨询过程中的发展变化进行描述。聚类分析的结果显示有3类工作同盟的发展模式, 分别是线性增长、线性下降和二次增长模式。不过, 3种发展模式、4个变化特征参数及同盟的破裂?修复片段对咨询效果均没有影响。比较咨询效果不同的当事人在工作同盟发展模式上的差异, 发现同一个发展模式对于不同的个案可能有着不同的含义, 咨询师在早期对同盟关系的处理与调控对咨询效果有着重要的影响。     

工作时间与工作绩效的非线性关系：一项元分析

基于42篇文献的64项独立研究, 总样本量为22843人的数据, 对工作时间与工作绩效的非线性关系进行了元分析。结果发现：(1)工作时间与任务绩效、关系绩效之间存在显著的倒U型关系; (2)国家类型的调节作用显著：相对于西方欧美国家, 工作时间与任务绩效、关系绩效的倒U型关系在中国更为显著; (3)产业类型的调节作用显著：相对于劳动、资本密集型产业, 工作时间与任务绩效的倒U型关系在知识密集型产业中更为显著; (4)年龄的调节作用显著：相对于高年龄水平, 工作时间与任务绩效的倒U型关系在低年龄水平群体中更为显著; (5)性别的调节作用显著：相对于低男性比例, 工作时间与关系绩效的倒U型关系在高男性比例群体中更为显著。结果不仅基于元分析厘清了工作时间与工作绩效的倒U型关系效应, 而且为劳动法中工时规定(例如周均工作时间不超过44小时)的合理性提供了科学依据, 警示组织注意工作时间对工作绩效的“过犹不及”效应。     

癫痫诊治中医患同盟建立的实践与策略

癫痫治疗目前仍以长期科学规范的药物治疗为主,为保证医生的治疗计划得到贯彻,在诊治中努力寻求医患同盟的建立尤为重要,让患者清楚地认识到医生对他的关注,认识到医生治疗的计划性、和具有应对各种情况的措施方法和能力,是寻求患方合作的基本条件。本文就医生首诊中的任务、人文关怀的重要性、如何共同进行药物选择、副反应规避、家属不良治疗心态纠正等问题进行探讨。     

人际同步性现象：探索心理咨询过程中同盟关系的新视角

人际同步性是指两个或两个以上的人的言语特点、行为表现、生理指标以及神经生理活动在时间上出现重合的现象, 得益于近10年内技术上的突破, 研究者开始对心理咨询领域的人际同步现象进行初步的探索, 试图从该视角揭示心理咨询过程中咨访双方的互动模式和同盟建立的内在机制。近期研究主要关注非言语同步、生理同步、人际脑同步与同盟及其影响因素之间的关系, 并针对它们各自对同盟的作用机制发展出了相应的理论。未来的研究者可以更多地关注同盟动态变化过程中的人际同步性, 发展整合理论来回应同盟建立的内在机制, 并在临床应用上促进具有人际同步性的心理咨询互动过程。     

当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

Developing the Working Alliance in Marital Therapy; A Psychodynamic Perspective

A good working alliance in marital therapy is one in which the partners are actively collaborating with their therapist to work through conflicts. The therapist begins to develop the alliance by setting the frame of therapy and helping the couple understand the guidelines of treatment. The partners gradually identify with and emulate the therapist's working style and use of self as a reflective instrument. The working alliance can be weakened by empathic failures and strengthened by increased feelings of trust in the therapist and the process of treatment This paper looks at the development of the working alliance in marital therapy from a psychodynamic perspective. A clinical illustration is included.     

Therapists’ perspective on the therapeutic relationship: Examining a tripartite model

The components of a tripartite model of the therapeutic relationship, namely the working alliance, the transference configuration (transference and countertransference), and real relationship, were examined in terms of how they relate to one another and to the outcome of a psychotherapy session, from the therapists’ perspective. Although previous studies have examined these components separately, no study to date has examined the components together in their relation to session outcome. Licensed psychotherapists (n = 249) were recruited from two Divisions of the American Psychological Association. Therapists completed measures for the last session they had with a client. Results revealed that from the therapist’s perspective the real relationship and working alliance related positively to session outcome, and countertransference behavior related negatively to session outcome. The components related to each other mostly as predicted by the tripartite model, and a principal-axis factor analysis revealed the presence of four distinct factors resembling the components theorized to comprise the tripartite model. The components together accounted for 27% of the variance in session outcome and only the real relationship and the working alliance predicted session outcome when all the components were looked at simultaneously in a regression model.     

The therapeutic alliance–A conceptual analysis

The role and function of the therapeutic alliance in psychotherapy has increasingly been the focus of clinicians' and researchers' interests over the last decade. Alliance concepts have, however, been criticized for lack of conceptual clarity. The paper presents a generic model as a heuristic means for clarifying the conceptual meaning of the therapeutic alliance. The model distinguishes between the personal relationship aspect, and the collaborative, task-related aspect of the alliance, with therapist, patient, and common contributions to each of these aspects. The model is compared to other alliance conceptualizations, and its implications for alliance theory and research are discussed. A content analysis of four widely used alliance scales in relation to the model shows the scales to represent conceptually different, yet overlapping constructs. It is argued that the componential nature of the therapeutic alliance will render difficult any interpretation of findings regarding the relationship between alliance and outcome in traditional process-outcome research. More complex research strategies guided by theory are called for, if the therapeutic alliance should remain a vital field of research.     

Promising New Developments in the Therapist–Client Relationship: A Philosophy of Science Review and Preview

Two questions were central: What are the current and what were the past new developments in the therapist–client relationship? By means of a “philosophy of science analysis,” what principles may be taken as helping to account for these new developments? Nine principles were identified in a review, including the articles in the present theme issue of the journal. The proposal and invitation are to use these nine principles to generate further, future, promising new developments in the therapist–client relationship.     

“The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist

The parent–therapist relationship is a central consideration in child counselling and psychotherapy, particularly in private practice where parents are typically financially, emotionally and practically invested in the process. The relationship, which can be ambiguous and anxiety-laden on both sides, has historically received scant attention in therapeutic discourse, leading to gaps in practitioner confidence and training. In this context, and seeking to centre parent voices, this study provides an interpretative phenomenological analysis of four mothers' experiences of their role in the relationship with their child's therapist. Key identified themes encompass parental expectation of involvement; the destabilising, disorienting nature of the relationship; the centrality of trust; and critical evaluations of value. Findings are discussed in relation to attachment theory and cultural expectations of parental responsibility. The study concludes that the relationship is a live and potent property with potential to impact the course of the intervention, and recommends that practitioners thoughtfully consider the potential benefits and drawbacks of meeting or frustrating parental involvement expectations.